GOALS:
With expanded use of anticoagulant agents, the number of patients receiving these drugs has increased dramatically. Safe and effective anticoagulation must include a number of key components to avoid complications. These include careful patient assessment, an understanding of the clotting cascade and mechanisms of action of anticoagulant drugs, a detailed focus on factors which influence therapy and knowledge of current guidelines. This certificate program is a comprehensive program designed to provide pharmacists with the basic knowledge and skills necessary to care for patients taking anticoagulation therapies. By completing this course, pharmacists can earn 21 ½ hours of continuing education credit while becoming certified in anticoagulation management. Join the growing number of pharmacists who are providing anticoagulation services.
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The Anticoagulation Practice Based Certificate Program is conducted in two parts: the didactic home study and the live workshop. To earn a Certificate of Achievement for the entire certificate training program, participants must successfully meet the following requirements:
1. Read the Home/Self Study Materials in their entirety and successfully complete the Self Study Assessment. A score of 70% or better is required.
2. Attend Conference: On Site Training and successfully complete the open book Final Exam. A score of 70% or better is required.
A Certificate of Achievement is awarded to participants who successfully complete all program requirements.
The didactic home study will consist of reading selected chapters from The Eighth ACCP Conference on Antithrombotic and Thrombolytic
Therapy: Evidence-Based Guidelines Chest 2008: accessible on-line via the following link: www.chestnet.org
, completing study guide questions, and an open-book post-test with a score of at least 70% correct responses. Upon registration, the home study portion will be e-mailed to you, so you must provide a working e-mail address on your registration form. There are 8 separate sections { (1) Heparin and Low-Molecular-Weight Heparin, (2) Pharmacology and Management of Vitamin K Antagonists, (3) Hemorrhagic Complications of
Anticoagulant Treatment, (4) Antithrombotic Therapy for Venous Thromboembolic Disease, (5) Antithrombotic Therapy in Atrial
Fibrillation, (6) Heparin Induced Thrombocytopenia, (7) Periprocedural Bridging, (8) Antiplatelet Chapter} each containing a required reading and study guide questions. Participants have four (4) weeks to complete the required readings, study guide assignments, and open book post-test. The study guide questions will be collected at the live CE program on March 12 th , 2010 and the self-study open book test must be completed on-line by no later than March 10 th , 2010. The home study portion must be completed in order to
participate in the live program. Pharmacists will receive CE credits of a total of 10 hours or 1.0 CEUs.
Learning Objectives
 Define thrombogenesis and hemostasis
 Differentiate the pharmacology and pharmacokinetics of UFH, LMWH, fondaparinux and warfarin
 Compare and contrast the pharmacology and pharmacokinetics of the antiplatelet agents such as Aspirin, Clopidogrel,
Prasugrel, and IIb/IIIa inhibitors.
 Describe the mechanisms of action of different agents used in treatment of thrombosis and their effects on the clotting cascade
 Describe the basics of warfarin dosing and monitoring.
 Review regulatory and clinical issues of home point of care monitors for warfarin.
 Define the current recommendations for indication-specific intensity and duration of warfarin therapy
 Identify risk factors for thromboembolism.
 Discuss therapeutic treatment strategies for the prevention and treatment of venous thromboembolism
 Identify and assess the anticoagulation needs of atrial fibrillation patients.
 Discuss the role of thrombolysis, UFH/LMWH, antiplatelet and oral anticoagulants in acute ischemic stroke patients.
 Describe the pathophysiology of atherosclerosis and acute coronary syndromes and relate this back to the antithrombin and antiplatelet agents used to manage this disorder
 Be able to identify onset of heparin induced thrombocytopenia and develop treatment strategies
 Interpret strategies used to manage hemorrhagic complications associated with warfarin
 Identify potential therapeutic targets for new anticoagulant development
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The live program involves 11 ½ hrs (1.15 CEUs) of both lecture and case-based training. All participants will focus on the pathophysiology of arterial and venous thrombosis, receive an overview of ACCP Guidelines and administrative management recommendations, discuss indications for anticoagulation therapy, management of the over-anticoagulated patient, review of heparininduced thrombocytopenia and patients requiring procedure management. Day 2 of the program is an interactive case-based program that will focus on either inpatient or outpatient management issues. Participants will choose which program they would like to attend.
DVD’s of the each case-based program will be made available for an additional fee of $25 for one or $40 for both. At the conclusion of the live program an open-book final exam must be completed with a score of at least 70% correct responses. The home-study program along with the didactic lecture series will be sufficient to prepare the participant for the examination. Pharmacists will receive a total of
11 ½ hrs or 1.15 CEUs for completion of this part.
Learning Objectives
Overview of ACCP Guidelines / Indications for Anticoagulation Therapy
 Describe guidelines or performance improvement initiatives directed at improving the safety and efficacy of anticoagulation therapy.
 Identify resources needed to manage the care of the anticoagulated patient and implement protocol or policy development.
 List the indications for anticoagulation therapy based on the recommendations of the:
 American College of Chest Physicians (ACCP
 American College of Cardiology/American Heart Association (ACC/AHA)
 American College of Physicians/American Academy of Family Physicians (ACP/AAFP)
Management of arterial thrombosis
 Develop anticoagulation or antiplatelet treatment plans for atrial fibrillation patients based upon the patient’s risk factors
(CHADS2 score), need for elective cardioversion or following cardiac surgery.
 Apply current literature and guidelines to develop treatment plans for ischemic stroke patients (cardio- and noncardioembolic).
 Compare and contrast the pharmacologic characteristics and therapeutic role of the various anti-platelet, anti-thrombin and fibrinolytic agents used to prevent and treat acute arterial thrombotic events
 Develop anticoagulation and anti-platelet treatment plans for the management of patients with acute coronary syndromes with and without percutaneous coronary intervention.
Management and prevention of venous thromboembolism
 Discuss current approaches to identifying candidates for deep vein thrombosis prophylaxis strategies
 Review the evidence addressing agent selection, intensity and duration of therapy
Periprocedural Management
 Be able to determine risk stratification of patient into low, moderate, or high thrombotic risk
 Define ACCP guidelines for peri-procedural management of warfarin therapy
 Discuss “bridging” therapy with UFH, LMWH and dosing regimens of each
Management of Supratherapeutic INRs
 Develop treatment plan for patient on Warfarin needing reversal (based on patient circumstances and INR).
 Develop a treatment plan for patients needing reversal of other agents (e.g. heparin, fondaparinux, DTI’s).
Heparin-induced thrombocytopenia (HIT)
 Review the pathophysiology of HIT development
 Discuss the clinical-pathologic diagnosis of HIT
 Develop anticoagulation treatment plans for management of HIT in various patient settings (ex. Acute renal failure, hepatic disease, etc)
New anticoagulants
 Describe the attributes of an ideal anticoagulant
 Review the investigational anticoagulant agents currently under development.
 Discuss how new anticoagulant agents may impact the utilization of warfarin and heparin
The New York State Council of Health-system Pharmacists is accredited by the Accreditation Council for
Pharmacy Education as a provider of continuing pharmacy education. This program will provide pharmacists with a total of 21 ½ hours of continuing education credit (2.15 CEUs) upon completion of this seminar.
DIDACTIC HOME-STUDY COMPONENT:
ACPE UPN#0134-0000-10-011-H01-P
(10 hrs.or 1.0 CEUs)
LIVE PROGRAM COMPONENT:
ACPE UPN#0134-0000-10-012-L01-P
PRACTICE BASED CERTIFICATE PROGRAM COMPONENT
ACPE UPN # 0134-0002
( 11 ½ hrs or 1.15 CEUs)
Practice based program
John Noviasky, BS, PharmD, Clinical Pharmacists, FNYSCHP, Associate Director Pharmacy-Clinical Services Upstate Medical Center,
Syracuse, NY
Lisa Phillips, PharmD, St. John Fisher College, Rochester, NY
Karen Whalen, RPh, BCPS, Drug Information Pharmacists, St. Joseph’s Hospital, Syracuse, NY
Kimberly Zammit, PharmD, BCPS, FASHP, Clinical Pharmacy Coordinator, Kaleida Heath-Buffalo General Hospital, Buffalo, NY
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All grievances regarding courses, personnel or practices at any continuing pharmacy education program should be brought to the attention of the Program Administrator/Executive Director. Every attempt will be made to satisfy the complainant. In addition, measures shall be taken to correct deficiencies. Those program participants who wish to appeal their participation at a program should address such an appeal in writing to the Program Administrator/Executive Director, New York State Council of Health-system
Pharmacists within 10 working days of the program. The Program Administrator will convene an appeal process committee consisting of the members of the CE Committee within 30 days after the filing of the appeal. The written results of the appeal will be shared with the participant within two weeks following the committee meeting.
Please register online at www.nyschp.org
by February 11, 2010. You may link to the conference website directly from the
NYSCHP home page. A $50 late fee will apply to all who register after February 11, 2010.
Fees: $350 NYSCHP members who register before 2/11/2010. $555 Non NYSCHP members who register by 2/11/2010.
• We reserve the right to cancel or change locations of the seminar due to insufficient registration; registrants will be notified and receive a full refund for cancellation.
• Cancellations received 60 days prior to each program may request a 90% refund. Paid registrants who fail to attend the live program will receive the 10 hours home-study certificate of completion when they turn their test in provided they attain a score of 70% or higher scores on home-study.
• Home study information will be sent to registrants by February 11, 2010.
• Hotel accommodations may be made at the Brookwood Inn.
http://www.thebrookwoodinn.com/ under the St John Fisher room block.
The registration fee includes CE statements of credit and a formal anticoagulation certificate. Registration fee does not include a copy of the Eighth ACCP Conference on Antithrombotic and Thrombolytic Therapy: Evidence-Based Guidelines as it is available free of charge online www.chestnet.org
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